You will need to replace the bold variables with your own settings, then upload the page to your website and test it.
Quick Test
The path to the script is ...
http://www.change-domain.com/cgi-bin/mailform.pl
To test you have the correct path, replace 'change-domain.com' with your own domain and insert it into your browser, you will see a standard script page confirming you have the correct path.
If no script message is seen, login to your Control Panel and make sure you have installed the 'Form Mail' script from the 'CGI Scripts' section.
Recipients
Additional security measures mean that the recipient email address you use in the form must be added to the 'allowed' list on the server. To do this, login to your user Control Panel and go to CGI Scripts / Mailform / Configure, then add each email address to the 'allowed' list.